中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2014年
2期
147-151
,共5页
张余%姚子龙%柯晋%张涛%马立敏%李梅%李丽华%欧阳兰飞%黄华扬%夏虹
張餘%姚子龍%柯晉%張濤%馬立敏%李梅%李麗華%歐暘蘭飛%黃華颺%夏虹
장여%요자룡%가진%장도%마립민%리매%리려화%구양란비%황화양%하홍
微波%消融技术%骨肉瘤%病理学,外科%随访研究
微波%消融技術%骨肉瘤%病理學,外科%隨訪研究
미파%소융기술%골육류%병이학,외과%수방연구
Microwave%Ablation technique%Osteosarcoma%Pathology,surgery%Follow-up study
目的：评价微波消融术治疗骨肉瘤的中期疗效，探讨瘤段骨的病理学转归。方法对1例股骨远端骨肉瘤，患者进行了原位微波消融＋内固定保肢治疗，术后随访43个月。末次随访时，拆除内固定，术中取股骨(原瘤段骨)中部、远端骨质及其周围软组织进行病理检查。结果该患者手术后53个月无瘤生存，肢体功能 MTST 评分30分。组织病理提示：瘤段骨中部见少量板层骨小梁、脂肪组织及再生的血管组织；瘤段骨远端骨质可见部分退变坏死及新生骨组织；股骨远端周围软组织镜下可见退变的横纹肌组织、胶原化的纤维结缔组织和神经组织。所有镜下均未见肿瘤细胞。结论该例接受微波消融治疗骨肉瘤患者的中期无瘤生存；术后43个月，原瘤段骨中仍有死骨存在，再血管化没有全部完成，仍有再骨折风险。
目的：評價微波消融術治療骨肉瘤的中期療效，探討瘤段骨的病理學轉歸。方法對1例股骨遠耑骨肉瘤，患者進行瞭原位微波消融＋內固定保肢治療，術後隨訪43箇月。末次隨訪時，拆除內固定，術中取股骨(原瘤段骨)中部、遠耑骨質及其週圍軟組織進行病理檢查。結果該患者手術後53箇月無瘤生存，肢體功能 MTST 評分30分。組織病理提示：瘤段骨中部見少量闆層骨小樑、脂肪組織及再生的血管組織；瘤段骨遠耑骨質可見部分退變壞死及新生骨組織；股骨遠耑週圍軟組織鏡下可見退變的橫紋肌組織、膠原化的纖維結締組織和神經組織。所有鏡下均未見腫瘤細胞。結論該例接受微波消融治療骨肉瘤患者的中期無瘤生存；術後43箇月，原瘤段骨中仍有死骨存在，再血管化沒有全部完成，仍有再骨摺風險。
목적：평개미파소융술치료골육류적중기료효，탐토류단골적병이학전귀。방법대1례고골원단골육류，환자진행료원위미파소융＋내고정보지치료，술후수방43개월。말차수방시，탁제내고정，술중취고골(원류단골)중부、원단골질급기주위연조직진행병리검사。결과해환자수술후53개월무류생존，지체공능 MTST 평분30분。조직병리제시：류단골중부견소량판층골소량、지방조직급재생적혈관조직；류단골원단골질가견부분퇴변배사급신생골조직；고골원단주위연조직경하가견퇴변적횡문기조직、효원화적섬유결체조직화신경조직。소유경하균미견종류세포。결론해례접수미파소융치료골육류환자적중기무류생존；술후43개월，원류단골중잉유사골존재，재혈관화몰유전부완성，잉유재골절풍험。
Objective To evaluate the mid-term clinical effects of the microwave ablation treatment of osteosarcoma and to investigate the pathological changes of the bone with tumors. Methods One patient with distal femoral osteosarcoma underwent microwave ablation in situ and limb salvage of internal ifxation, who was followed up for 43 months after the operation. In the latest follow-up, the internal ifxator was removed, and the pathological examination was carried out in the middle ( with primary tumors ) and distal femur and the surrounding the soft tissues. Results The patient was disease-free for 53 months after the operation. The Musculoskeletal Tumor Society ( MSTS ) scoring system was used to evaluate the joint function, and the score for the patient was 30 points. The pathological examination results were stated as following. There were some lamella trabeculas, adipose tissues and regenerative vascular tissues in the middle tumor-bearing femur. In the distal tumor-bearing femur, both partial degeneration and necrosis of the bone and formation of fresh bone tissues could be observed. Meanwhile, degenerated striated muscles, collagenous ifbrillar connective tissues and nervous tissues could be noticed in the surrounding soft tissues of the distal femur microscopically. No residual tumor cells were found microscopically. Conclusions Excellent mid-term clinical effects are obtained in this patient undergoing the microwave ablation treatment of osteosarcoma, who is free of cancer now. Necrosis of the bone still exists and complete revascularization can not been observed in the treated segment at 43 months after the operation, which predicts the possibility of postoperative fractures.
